Inspection on 09/04/05 for Chasefield House

This inspection was carried out on 9th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Chasefield House 26/06/07

Chasefield House 19/02/07

Chasefield House 31/01/06

Chasefield House 04/11/04

Chasefield House 26/04/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Chasefield House 888 Fishponds Road Fishponds Bristol BS16 3XB Lead Inspector Andrew Pollard Announced 09 April 2005 09:45 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Chasefield House Version 1.10 Page 3 SERVICE INFORMATION Name of service Chasefield House Address 888 Fishponds Road Fishponds Bristol BS16 3XB 0117 9653750 0117 9709301 Aspects Milestones Trust Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Mike Rogers CRH N 17 Category(ies) of LD Learning disability 17 registration, with number of places Chasefield House Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Staffing Notice dated 30/01/1995 applies Manager must be a RN on parts 5 or 14 of the NMC register May accommodate up to 17 persons aged 18 and over requiring nursing care. Date of last inspection 4-Nov-2004 Announced Brief Description of the Service: Chasefield is registered as a Care Home with nursing for 17 adults with learning difficulties.The house is situated in an urban location and can easily be accessed by car or bus.The nearby Fishponds Road high street is a busy shopping centre and has various social and community facilities.The house is a converted older property providing double and single rooms in three areas. There are two lounges, a dining room and a well-equipped workshop.The house has an extensive rear garden and vegetable garden, which residents can help maintain. Chasefield House Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The following methods of evidence gathering has been used in the production of this report; observation, pre-inspection questionnaire, discussion with residents and staff, relative and residents comment cards, tour of the home and sampling policies, records, care plans, meals. The building is large and old and would not be suitable as it is for people with physical disability and the frail elderly. This is of concern due to the increasing age profile of the current resident group. A consultation is underway at present with regard to improving and updating the environment and making better use of the buildings in the grounds. Various proposals have been submitted to the Commission. Discussions are taking place with regard to amending the conditions of registration to vary the staffing notice and numbers of persons to be accommodated and widen the categories of care. Chasefield is a well run home offering a good standard of care and quality of life. The inspector’s overall impression was that the residents were happy, settled and secure which was evident from observations and conversation with residents during the inspection. The staff demonstrated their commitment to enhance the quality of life for residents. During the visit the inspector spoke to a number of residents, who made positive comments about the home. It was clear from discussions with residents and from information available at the Home that residents were afforded the opportunity to attend a varied range of social and therapeutic leisure activities and there is a commitment to enhance these activities. The food served at the home was varied and nutritious and residents clearly enjoyed the range of meals available and have an increasing say in how the menus are constructed. Staff were observed talking with residents in a sensitive and friendly manner. Some staff have been working with the residents for many years and have an in depth knowledge and understanding of their needs. It was apparent that the staff have a good rapport with the residents. What the service does well: The manager and staff demonstrate a commitment to working toward a fully person- centred care regime in the home and the empowerment of residents. Residents are treated as individuals, with respect and dignity. People are given the opportunity to attend a varied range of social and therapeutic leisure activities and there is a commitment to enhance these activities. Chasefield House Version 1.10 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Chasefield House Version 1.10 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Chasefield House Version 1.10 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4 Prospective residents are given information in written or verbal form about the home. The assessment process is rigorous and detailed. Introductory visits are arranged for prospective residents. EVIDENCE: The statement of purpose and accompanying service user guide are being reviewed and updated and a business plan has been added. The documents had been written in a straightforward way and were easy to understand. All residents are admitted via Social Services through the placement team and the community nursing learning disability team. A prospective resident has been identified to fill a vacancy at the home. The manager has assessed their needs and the home’s ability to meet the needs, and gathered information from a consultant, social worker, OT and the training centre. One visit has taken place and several more are planned prior to admission. Speech therapy and health assessments are being carried out. The person centred assessment records includes information about important events in the person’s life, a detailed assessment of care needs, general likes and dislikes, preferred social activities, and choice of diet. Chasefield House Version 1.10 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9 Residents are involved with the assessment and care planning/goal setting process The homes philosophy promotes resident’s individual development and selfdirection and empowerment. EVIDENCE: Chasefield House Version 1.10 Page 10 The named nurse and key worker system is established in the home There were care plans in place, which aimed to address the physical, mental, and social needs of the person using a person centred approach. A new pictogram document is in use to support this approach. All goals and care plans are reviewed six monthly. Essential lifestyle planning is being be introduced slowly due to a recent large turnover of staff. Four files were reviewed and in general the care plans are detailed and comprehensive, one required updating. The records included evidence that residents had been consulted where practical in planning their care. The inspector discussed with the manager the need to back file old information and keep the files as current working documents. All residents have individual risk assessments in their files. There was detailed information included about any potential risks and risk behaviours that may be exhibited. Any restrictions of liberty or choice are supported by a risk assessment and care plan. In discussion with the staff on duty they conveyed that they understood that one key aim of the Home was to support residents with appropriate risk taking within the community. Residents were seen going out to the local shops accompanied by staff, during the inspection. A copy of the minutes for the last residents meeting was seen and showed that resident’s were consulted about a range of in house matters and their ideas for social and recreational activities. Resident’s views were canvassed regarding recent staff recruitment. A new photo menu pack is being produced with the chef to improve the resident’s involvement with menu planning and identifying their likes and dislikes more accurately. Residents are given choice over colours and fabrics for redecoration and in some cases assist with painting their own rooms. Chasefield House Version 1.10 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12,14 Residents have opportunities to take part in a range of community and leisure activities. The recreational and occupational arrangements in the home are well organised and varied. EVIDENCE: Chasefield House Version 1.10 Page 12 Residents attend the St George resource and activity centres, Alexandra Park adult education centre, the Lawrence link centre and Emerson’s Green art project. Other people attend Elms farm and have activities planned by day care staff. Some residents attend the workshop in the grounds with day care staff. A full and part time day care worker are employed. A gardener has been recruited and residents who are interested will work in the gardens and on the vegetable plot, which is looking very much improved since the last inspection. A part time agency cook has been recruited and it is intended that he will work some hours in the recently upgraded training kitchen with residents. The recent introduction of reflexology sessions has been a big success. Depending on their wishes individual residents are encouraged to engage with the local community. They are encouraged and assisted to attend local community services and facilities. Regular outings are arranged and annual holidays to Torquay and the Isle of White are planned. A timetable of activities showed residents were able to attend a range of therapeutic, social and recreational activities. Some residents were able to tell the inspector about the opportunities they have to attend activities the library, cinema, pubs, bowling and swimming. Certificates of achievement were displayed in bedrooms showing that residents had attended classes such as pottery, and arts classes. The home has an account with the Hippodrome and residents have the chance to see many of the productions staged there. Several of the residents attend a local church from time to time. Chasefield House Version 1.10 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20 The staff provides appropriate personal and nursing care in a sensitive manner to maintains residents health and well-being. Proper arrangements are in place for residents to access primary healthcare services. The staff properly manage and administer medication. EVIDENCE: Chasefield House Version 1.10 Page 14 The Home operates a key worker system to build close relationships with residents. A Registered nurse heads up each team of support workers. Care plans are written in a way to maximise people’s independence. One resident told the inspector that they had a ‘key worker’ who helped them. All the residents require prompting or support to manage their personal care. It was observed that residents were well dressed and groomed and wore clothes that were individual in taste. All residents are registered with a local GP with whom the home has a good working relationship. The doctor carries out an annual physical health check for each resident. Whenever possible the community services for dental and optical care are utilised however arrangements can be made for domiciliary visits if need be. Records of all such interventions are made in the case file. The chiropodist visits all residents at the home. The three resident comment cards and discussions with residents confirmed they felt well cared for in the home. The consultant Dr Carpenter visits about every three months and has carried out medication reviews reducing many prescriptions. Medication is ordered and delivered every 28 days, which enables good stock control. The MAR is from the Lloyds Pharmacy MDS system, which will allow for drug receipts to be recorded and do away with the receipts book, however there is a separate disposal record book. The storage, receipt, administration, and disposal records were up to date and in good order. The administration system has not yet changed but should be complete soon. None of the residents are able to manage their own medication. Each resident is to have an updated drug profile with the MAR. The suction machine is in working order and properly equipped and is easily assessable. The Trust has procedure to follow in the event of the death of a resident whilst at the Home. Chasefield House Version 1.10 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 There are robust and comprehensive policies in place to manage complaints or allegations of abuse. There are good arrangements in place for staff training and awareness of POVA matters. EVIDENCE: The complaint procedure is prominently displayed in the hallway. The contact information for the area office of CSCI was included. There is a complaints procedure written using symbols that would be accessible to some residents. The complaints record that showed no complaints have been received. All the comment cards from relatives and residents indicated no complaints. The Trust has a whistle blowing procedure in place called “do the right thing” which is kept in the polices and procedures file. The DOH guidance is available and there was a copy of the Bristol and South Gloucester Local Authority “No Secrets” guidance in the home. All staff have received “alerter” level of training related to the Trusts policies. The personnel department of the Trust carry out criminal record and POVA checks on employees. There have been no reported POVA incidents. There is little aggression displayed by residents although there are occasional incidents, however all staff receive two days of training in breakaway techniques. Chasefield House Version 1.10 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,28,30 The home is generally well maintained clean, safe and comfortable. Bedrooms suit the needs and tastes of the residents. EVIDENCE: There are detailed plans drawn up for the redevelopment of Chasefield, which will provide bed-sit type accommodation on the first floor and other bedrooms having en-suites built although there is no firm date for this work to commence. There are 3 shared rooms at present. Residents have been consulted about sharing and at present all concerned are wishing to continue as they are. Bedrooms were clean and tidy and extensively personalised with artwork, photographs and personal items. Several of the residents showed me their rooms and seemed very pleased with them. Two people said they enjoyed sharing. All bedrooms were decorated in individual styles and where able to residents had been involved in the choices of colours for their room and to a limited extent the decoration. Bedrooms are not en suite, but there was a hand washbasin in each room. The lower bathroom is to be upgraded in the coming weeks. Chasefield House Version 1.10 Page 17 There was a good quality pine wooden wardrobe, and a chest of drawers in each room. Not all bedroom doors have a lockable facility, however residents have been asked if they would like a lock and key, which can be provided if requested. There are several communal areas, including two main lounge areas, a dining room in the basement, an activity room and a small therapy area. There are some adaptations such as handrails and a bath hoist in the home however at present the home is not suitable for severe mobility problems. The home was clean and hygienic. There were no malodours. Laundry facilities are suitable and an additional dryer has been purchased. Some residents are able to take part in doing their own laundry. There is a large workshop located in the bottom of the garden. There is a large garden, which is divided into areas that are used for recreation and growing, plants and fruit. This area benefited from a recent makeover from a team from the local HSBC bank. Chasefield House Version 1.10 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,35 The home is adequately staffed with appropriately trained and experienced staff. The recruitment procedures and records are in good order. Proper training arrangements are in place for care staff. clinical updating for RN’s needs to be improved. EVIDENCE: Chasefield House Version 1.10 Page 19 The Home is registered to provide nursing care and there is a registered nurse on duty at the Home over twenty-four hours. Three staff work the night duty, one registered nurse is available on a ‘sleeping in shift’ and two care assistants work a waking night shift. The nurse staffing levels are in accord with the notice issued by Avon Health Authority. The manager works entirely supernumerary hours. An amendment to the staffing notice was discussed to remove the sleep in provision and have one RN and a support worker on a waking night shift. It was also confirmed that the manager was only required to work 19.5 supernumerary hours each week. An application to amend the staffing notice is likely to be submitted. The majority of the staff are long standing and have considerable experience working with this resident group. However seven staff recently left around the same time, which did require a high usage of bank and agency staff. Interviews have been carried out and appointments made to replace them. There is adequate provision of ancillary staff, Housekeeping, Catering, and Gardening staff. There are two day-care workers employed. Staff were observed talking with residents in a sensitive and friendly manner. The Trust has put copies of recruitment documentation into the home and those files examined were in good order. The HR department has carried out NMC and CRB/POVA checks. All new recruits are linked to a mentor and complete a standard Trust induction process and in addition an in house orientation linked to LADAF standards. The RN training records will be reviewed at the next inspection, the manager felt there had been a lack of clinical updating recently. Ms Oakley has taken responsibility for the co-ordinating compulsory training including Health and Safety (H&S), load handling, 1st aid, and food hygiene and fire safety. The training records did show a consistent pattern of staff completing this training. The Trust does facilitate or provide a range of training opportunities, which was felt to be improved recently in both scope and access other than Clinical training for RN’s. Chasefield House Version 1.10 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39,42 There are various methods and systems in place to obtain residents views. The formal QA system requires updating. There are appropriate arrangements in place to service and repair plant and equipment. The home has good Health and Safety arrangements. EVIDENCE: Chasefield House Version 1.10 Page 21 A copy of the minutes for the last residents meeting was seen, which, showed that residents were consulted about a range of in house matters. A key worker system and IPP/ELP systems are in place with regular team meetings and reviews. Annual social service reviews are completed for each resident. There are a set of house quality standards, which are reviewed monthly, it was agreed that these required revising and rewriting as the same standards had been in use for many years and some were out of date. A pictorial resident satisfaction survey has been carried out last year and the outcomes were positive as far as it went. The manager considers this document is of limited value with the current resident group and is looking to develop anew tool in due course. Resident and relative feedback through the comment cards was positive one person saying “if all homes were like this there would be no need for inspection” All of the residents who responded said they liked living at Chasefield were well treated and enjoyed the food and activities. The Trust has Health & Safety policies and procedures and H&S audits are carried out regularly. A fire risk assessment under the work place regulations has been completed. A recent Fire officer visit has been carried out from which there are no requirements. The home has a copy of the new infection control manual. There are proper arrangements to deal with clinical waste. PAT, gas and alarm system have ben serviced. Arrangements to test the hoists were made during the inspection. The periodic electrical installation safety certificate has been renewed. Hot water temperatures are monitored and logged. SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: Chasefield House Version 1.10 Page 22 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x x 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 x 3 x x x Standard No 31 32 33 34 35 36 Score x 3 3 x 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 2 x x 3 x Chasefield House Version 1.10 Page 23 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 35 39 Good Practice Recommendations write a stratergy for maintaining RN clinical updating in accord wit PREP requirements. Revise and update the monthly qualitystandards. Devise a resident survey tool. Chasefield House Version 1.10 Page 24 Commission for Social Care Inspection 300 Aztec West Almondsbury South Gloucestershire BS32 4RG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Chasefield House Version 1.10 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!